急性过氧化氢中毒致肝内门静脉积气及高乳酸血症1例报告

A Case Report of Acute Hydrogen Peroxide Poisoning Leading to Intrahepatic Portal Vein Gas Accumulation and Hyperlactatemia

摘要: 过氧化氢(双氧水)口服中毒在临床中相对少见，但其引起的局部腐蚀效应和因分解产气导致的栓塞风险可危及生命。本文报告一例51岁男性患者，因自服3%过氧化氢100 ml后出现恶心、腹胀等症状2小时余入院。诊疗过程中，患者出现一过性肝内门静脉积气及高乳酸血症等特征性表现。经积极对症支持治疗，病情好转。本文旨在通过此病例，结合文献复习，深入探讨低浓度过氧化氢中毒的病理生理机制、诊断要点、治疗策略及潜在风险，强调即使摄入低浓度溶液，若剂量较大，亦需引起临床高度重视。

Abstract: Oral hydrogen peroxide (H₂O₂) poisoning is relatively rare in clinical practice, but its local corrosive effects and the risk of embolism caused by gas decomposition can be life-threatening. This article reports a 51-year-old male patient who was admitted to the hospital after taking 100 ml of 3% hydrogen peroxide and experiencing symptoms such as nausea and bloating for more than 2 hours. During the diagnosis and treatment process, the patient exhibited characteristic symptoms such as transient intrahepatic portal vein gas accumulation and hyperlactatemia. After active symptomatic supportive treatment, the condition improved. This article aims to explore in depth the pathophysiological mechanisms, diagnostic points, treatment strategies, and potential risks of low-concentration hydrogen peroxide poisoning through this case and literature review. It emphasizes that even if a low concentration solution is ingested, if the dose is large, it should still be highly valued in clinical practice.